NIH Leader Outlines Future
of U.S. Medical Research

Elias A. Zerhouni, M.D., director of the U.S. National Institutes of Health (NIH), spoke of his vision for research and medical discovery in the 21st Century, during the Annual Meeting of the American Association for the Advancement of Science (AAAS).

Part of The U.S. Department of Health and Human Services, NIH is the principal funding source for biomedical research in the United States, and its funding decisions have a significant impact on medical research worldwide.

"The NIH needs to proactively define initiatives to advance science and to decide what science to advance," Zerhouni said. "While we have discovered the component parts of the human genome, for example, the real challenge for the 21st century is to discover how all the parts work together. Biomedical research in the year 2002 is at a turning point that will require new strategies."

The quest will require multidisciplinary teams and cross-cutting initiatives, he said, as well as the "creative spark of the individual that leads to new knowledge and progress."

Zerhouni said that these efforts must cross NIH institutes and centers and integrate multiple disciplines, while addressing the needs and concerns of the public. He said he would focus on four areas that would allow NIH to benefit the global biomedical research community:

• Revolutionary Methods of Research,
• New Pathways to Discovery,
• Multi-Disciplinary Research Teams of the Future, and
• Re-Engineering the Clinical Research Enterprise.

Zerhouni developed his "roadmap initiative" shortly after he became the NIH Director in late May 2002, based on meetings with scientists both in and outside government. In his talk, he described the steps NIH would take to implement the plan, whose main goal is to improve the health of the American public.

Zerhouni — who has also been vice dean for research at Johns Hopkins University as well as a member of the National Academy of Science's Institute of Medicine, acknowledged that advances in genome and stem cell science have given rise to "deep moral issues" and that the debate over such issues "can be polarizing." But he adds that, "Disease knows no politics — NIH must serve all of us...it must not be factional, but must remain factual."

"Science is evolving at such a pace that cross-cutting initiatives need to be encouraged," he continued. He said he would work to enhance interactions among scientists, identify bottlenecks to research progress and address them.

14 February 2003